Archive for the ‘Retail Clinics’ Category

Aging demographics, population health, accountable care initiatives, and the rapid growth of retail healthcare clinics are all affecting talent management practices in the healthcare industry, according to a new study by HealthcareSource and the American Society for Healthcare Human Resources Administration (ASHHRA).

A new infographic by the two organizations breakdowns key data points from the study.

From cost pressures, consumerism and consolidation to a proliferation of patient-centered, value-based delivery and payment models, the state of healthcare continues to challenge organizations in the industry.

In this week’s issue, learn about a retail clinic now offering health monitoring services for certain conditions, as well as gender differences in exercise by cardiac patients. You will also discover the risks that diabetes can pose in patients needing cancer surgery.

In addition, get the latest metrics in obesity and weight management by completing our new e-survey by April 30. Tell us what your organization is doing to reduce obesity.

The number of retail clinics is growing. Nearly 30 percent of parents report having a retail clinic in their community, making this emerging source of healthcare for children often simpler and more accessible than an appointment at a doctor’s office.

In communities with nearby retail clinics, one in six parents have taken their children there for care, while one in four parents are likely in the future to take their children to a nearby retail clinic for care.

When it comes to healthcare technologies, we are in the golden age. Need proof? Ladies and gentlemen, I give you Exhibit A: the Telemedicine clinic. Recently, My Healthy Access, Inc. and NuPhysicia signed off on a joint-operating agreement to run Telemedicine clinics in select Wal-Marts in the Houston area. The clinics, Walk-In Telemedicine Health Care, allow physicians to meet with patients virtually while on-site paramedics examine patients under direct supervision of a PCP.

“Simply put, the paramedic serves as the ‘hands’ of the physician, who uses medical devices such as an electronic stethoscope to listen to the heart, or other scopes that can see down the throat or in the ears — and the physician sees and hears everything live and in real time,” said Glenn G. Hammack, president of NuPhysicia. “The physician performs the exam as if he or she was in the room with the patient.”

These retail clinics boast taking convenient care one step further by essentially cutting out the NP and providing the patient with an interactive visit with the PCP.

Exhibit B: The Northwest Telehealth network — a service offered to Washington prisoners that allows them to attend sessions with their psychiatrists, obtain prescription medications via a vending machine and “teleconsult” with dieticians to manage chronic conditions like diabetes.

Telehealth’s benefits are threefold: These virtual visits save tax dollars, improve safety by cutting back on transporting prisoners to and from points of care and discourage prisoners from faking symptoms in order to leave the prison and go to the ED. This results in a decrease in ED visits from prisoners, which, according to Gram McGregor, ED manager at Deaconess Medical Center in Spokane, Wash., an ED in close proximity to Washington’s Ridge Corrections Center, 50 percent of the inmates that come to his ED do not need to be there.

But like everything else in life, you have to take the good with the bad, and healthcare technologies are no different. The director of the University of Pittsburgh Cancer Institute (UPCI) warned his faculty to limit their cell phone use as it could be linked to cancer. Dr. Ronald B. Herberman warns to take precautions now regarding cell phone use:

“Really at the heart of my concern is that we shouldn’t wait for a definitive study to come out, but err on the side of being safe rather than sorry later,” Dr. Herberman said.

And finally, Nintendo’s Wii Fit isn’t doing as much good as some gamers might like to think. The American Council on Exercise (ACE) announced the results of its study on the potential fitness benefits of the game.

“With interactive video games becoming more popular than ever before and Americans now spending an average of 19 to 25 hours per week watching TV and playing video games, we set out to discover whether or not the Wii is truly beneficial as an exercise tool,” said Cedric X. Bryant, Ph.D., chief science officer. “While they have managed to get traditional gamers off the couch and our results show that Wii Sports offer more of a cardio benefit than sedentary games, we believe there is no substitute for the real sport.”

Moreover, the study finds that boxing was the only Wii game intense enough to maintain or improve cardiorespiratory endurance, as defined by industry standards.

Like electronic health records, quality data reporting and emerging primary care models, retail clinics are here to stay. Physician practices, health plans and even hospital emergency departments must decide whether to compete or coexist. This week, Humana and Sutter Health — a payor and provider in the retail clinic space — gave us food for thought, sharing their experiences with reimbursing for and running retail clinics.

Dr. Steven Goldberg, corporate medical director at Humana, which includes MinuteClinic in its provider network, describes the very early feedback his organization has received:

Are retail clinics a good thing? Well, that depends on your vantage point. A couple things: the rate of clinic visits has dramatically increased over the past years. I believe recent published literature shows about 1,000 such clinics now, and hundreds of thousands of visits. In general, the consumer experience has been very good, and that’s a very positive thing. For the narrow scope of services, the experience has overall been consistently reported in sources as very, very positive. As a payor, we really look at this in the context of a range of approaches for these types of problems and settings. How does a retail clinic stack up for issues versus self management, versus urgent care, versus primary care, versus ER care? The public domain literature is very limited. Our findings are early. As far as quality, the general experience for the scope of services is very positive, and people in general seem to be pleased with cost. Frankly, they are walking with their feet and walking more and more every day. As far as continuity, that remains something that we have to follow more.

Offering the provider perspective was Dr. Thomas N. Atkins, medical director of Sutter Express Care, six drugstore-based medical clinics that are part of Sutter Health’s network of hospitals and doctors serving Northern California. There were enormous administrative and regulatory hurdles to overcome in the establishment of the clinics, Dr. Atkins said.

On clinics’ critical success factors:

It’s important if you want to be as successful as you can that you be first to market. I think it’s much more difficult to try and establish these behind another provider that puts these in in a community.

On fears voiced by health plans:

There’s some evidence that in some areas or for some conditions, patients will see someone in these retail clinics and then go see their doctor anyways, and that’s the kind of thing that increases utilization that is disturbing to the health plans. And the one health plan that didn’t contract with us, felt that that was what was going to happen. Now, their patients were really upset because we had that contract last year, we didn’t this year, and these patients have been coming in and being patronizing for us, and they were just, they were really upset about not being able to have this service covered for them. The patients to the clinics are quite loyal.

On why typical hospital marketing does not work for this kind of a project:

The nurse practitioner or the physician assistant is of course the patient care giver, educator, counselor, customer service rep. This piece here is really important. These people need to for the most part be extroverts; we really encourage them to walk around in the aisles and wear their clinic coat to Starbucks when they take a break. They have to take on a marketing role to help sell the clinics to their community. They often will go visit local stores and employers as well. …They are the face of Sutter Express Care.

Recently, CheckUps, retail clinics operating in Wal-marts, closed 23 of its 81 locations, citing debt and the inability to pay its medical staff and vendors. However, Wal-mart executives are still planning to lease space to several hundred clinics over the next two years and to offer space to up to 2,000 clinics in the next six years.

While this news isn’t slowing down the superstore, how will other organizations react to it? Will the results for this organization have an effect on retail clinic strategies of other organizations? Is this a warning for other retail clinics?

During a recent HealthSounds podcast, HIN spoke with Dr. Thomas Atkins, medical director of Sutter Express Care, drugstore-based medical clinics that are part of Sutter Health’s network of hospitals and doctors serving northern California, about establishing locations for retail clinics, sharing information with PCPs and the impact retail clinics can have on reducing non-emergent ED usage as well as healthcare costs.

Dr. Atkins says there are several lessons to learn from Wal-mart’s situation.

“Different clinics will react differently to that news,” says Dr. Atkins. He remarked that commercial operators of retail clinics will look closely at the implications this announcement has for the way that they conduct their business.

Dr. Atkins also noted that organizations like Wal-mart that house these retail clinics will now think twice about their investments with these clinics, specifically regarding the size and space used for the clinics and the reliability of those they contract with.

Retail clinics are one of the hottest trends right now in the healthcare industry. Of the 65 healthcare providers that responded to HIN’s e-survey on retail clinics, 58.5 percent of them viewed retail clinics as an opportunity for their businesses rather than a threat. Now that I know a little more about these facilities, I can see why they are so popular and why their numbers are increasing nationwide.

Retail clinics seem to fit in perfectly with the fast-paced society we live in today. Who has time to wait in waiting rooms, only to be called into the examining room to wait some more? After all that waiting, patients are often directed to the pharmacy to fill a prescription. By that time, a valuable morning or afternoon is spent, not to mention a lot of cash.

Retail clinics are the modern man’s (or woman’s) alternative to the traditional doctor’s visit. This culture is all about saving time and saving moneyÃ¢â‚¬â€two of retail clinics’ biggest selling points.

However, in a recent HIN e-survey, some providers referred to retail clinics as a Ã¢â‚¬Å“doc-in-a-box,Ã¢â‚¬Â and raised questions about the quality of care retail clinics can give to patients, saying the nurse practitioners and physician assistants operating such facilities do not have the ongoing relationship that patients are likely to have with their PCPs.

Studies predict that by the end of next year, there will be close to 3,000 retail clinics operating nationwide. In fact, recently, Great-West Healthcare, a national employee benefits provider, has taken on MinuteClinic, the pioneer and largest provider of retail healthcare in the United States, as a participating provider.

It will be interesting to see the reaction to such clinics, from a consumer’s point of view as well as from the healthcare industry. Will this phenomenon continue to catch on with the rest of the country like it has been thus far? Or will people tend to stick to their traditional and familiar means of healthcare? We’ll have to wait and see what 2008 holds for retail clinics.

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